Primary healthcare service delivery for older people with progressive multimorbidity in low- and middle-income countries: a systematic review
Author:
Kwaitana Duncan1ORCID,
Chisoni Felix1,
van Breevoort Dorothee1,
Mildestvedt Thomas2,
Meland Eivind2,
Bates Jane1,
Umar Eric1
Affiliation:
1. Kamuzu University of Health Sciences , Blantyre , Malawi
2. University of Bergen , Oslo , Norway
Abstract
ABSTRACT
Ensuring primary healthcare (PHC) accessibility to older people with multimorbidity is vital in preventing unnecessary health deterioration. However, older people ≥50 y of age in low- and middle-income countries (LMICs) face challenges in effectively accessing and utilizing PHC. A systematic review was conducted adopting the Andersen–Newman theoretical framework for health services utilization to assess evidence on factors that affect access to PHC by older people. This framework predicts that a series of factors (predisposing, enabling and need factors) influence the utilization of health services by people in general. Seven publications were identified and a narrative analytical method revealed limited research in this area. Facilitating factors included family support, closeness to the PHC facility, friendly service providers and improved functional status of the older people. Barriers included long distance and disjointed PHC services, fewer health professionals and a lack of person-centred care. The following needs were identified: increasing the number of health professionals, provision of PHC services under one roof and regular screening services. There is a need for more investment in infrastructure development, coordination of service delivery and capacity building of service providers in LMICs to improve access and utilization of PHC services for older people.
Funder
University of Bergen
Royal Society of Tropical Medicine and Hygiene
Publisher
Oxford University Press (OUP)
Subject
Infectious Diseases,Public Health, Environmental and Occupational Health,General Medicine,Parasitology
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